Imagine with me, it’s January and you are at work. You start to feel aching in your muscles and more tired than normal. Maybe you overdid it shoveling snow a couple of days ago. Maybe you slept wrong.

Unfortunately, within the next 24 hours, you feel worse. You develop a headache. Your eyes burn and feel heavy. Your nose drips like a faucet one minute and swells closed the next. Then the cough comes – first a tickle, then the fits. Your spouse kindly says “You look terrible,” and digs out the questionable thermometer from the dusty medical bag in the bathroom. Beep. 101°F. You haven’t had a fever in more than 5 years. You call in sick to work – the first time ever legitimately sick. Something is wrong.

The Google search is not helpful, suggesting possible diagnoses from seasonal allergies to metastatic cancer. The expired medications in the cabinet have unpronounceable ingredients and warnings that make you question their safety. Toughing it out with Gatorade and a shower sounds like the most reasonable option. However, by day four, you’re really worried. You break down and call the clinic.

They squeeze you in that afternoon. As you check in, the receptionist informs you that because of your symptoms, the doctor has recommended some tests and you are ushered to the lab. Three cotton swabs and several sneezes later, you’re finally in the exam room. You provide your history to the medical assistant, and soon the doctor is in. After a short, painless exam and review of your negative lab results, the doc reveals the diagnosis.

You have a viral URI – an upper respiratory infection – a common cold.

Some over-the-counter medications, fluids, and time are recommended. Thankfully, you are given a note to excuse you from work and reassurance that you are going to survive. “Come back if you don’t get better.” Like magic, over the next few days, you start to feel better.

Then, a week or two or four later, the mail arrives. First, it’s the EOB from the health insurance company with tables and summaries of “responsibilities”. Next, comes the letter from the clinic with your actual bill. Your heart rate quickens as you open the envelope.

$945.

WHAT THE …?!

That can’t be right. All you had was a cold, right? You start to investigate and find out that the appointment was $140, the three lab tests were $250 each, the pulse ox they checked on your finger was $25, and the depression questionnaire you completed at check in was $30.

What about your insurance? After all, a few hundred dollars comes out of your paycheck every month for that. Surely it’ll cover these charges. After 30 minutes on the phone with your health insurance company, you are reminded that you have a $4,000 deductible. Your health insurance will be M.I.A. until you meet your deductible. The $945 is yours to pay, to worry about, to finance, or to let go to collections.

How do you feel? Are you in disbelief, angry, frustrated, ashamed, confused, sad?

What happens the next time you get sick? Do you hesitate to get care?

Moreover, what if you are overdue for preventative care such as cancer screening, a vaccine, or cholesterol check? Are you more suspicious? Do you go?

The numbers used here are just estimates, but, unfortunately, for some of you this may feel more like a recent reality than a fictional story. This patient has been you. As a primary care provider and often the face of the health care system, the doc in this story has been me. Hear me say, “I am sorry.”

Really, I am.

Can we all agree that getting care for an uncomplicated URI should be less than $900 -regardless if you, the government, or an insurance company is paying? (That’s 9 months of unlimited care at a “DPC” clinic, by the way.)

Let’s stop making excuses and tolerating a bad system. Let’s make the cost of primary care transparent and affordable. Let’s keep people healthy AND prevent them from going bankrupt.